Introduction: Incorporating digital technologies has been recently gaining popularity because of the known benefits like increased accuracy, predictable outcomes and reduction in treatment time. It is very important for the clinicians to analyse the necessity of incorporating these digital approaches into routine patient care. Aim: To assess the knowledge, attitude and practice of dental practitioners towards Computer Guided Implant Surgery (CGIS) in Central India. Materials and Methods: A cross-sectional study was conducted in the Department of Prosthodontics at the Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Nagpur, Maharashtra, India, to assess the attitude towards CGIS and Non Computer Guided Implant Surgery (non CGIS) by analysing responses from a total of 100 dental practitioners. A questionnaire consisting of 30 questions was circulated through a web based program. Analysis was done using descriptive and inferential statistics using the Kruskal Wallis test and the Mann Whitney U test. Responses were collected and analysis was performed using Statistical Analysis for the Social Sciences (SPSS) 27.0 version. Results: Around 100 participants were included in the survey. 52 participants were female and the remaining 48 were male. Among all 97 (97%) participants were interested in CGIS but only 40 (40%) participants had any previous experience with the technology. Increased accuracy (z=7.08, p=0.0001) and predictability (z=10.64,p=0.0001) were considered the significant advantages by the participants. The overall difference in attitudes of CGIS and non CGIS users towards increased accuracy of CGIS was not statistically significant. (z=0.394, p=0.694). Conclusion: The advantages of CGIS over non CGIS were acknowledged by majority of the practitioners. The major advantages were related to the greater accuracy and predictability associated with CGIS whereas the limited accessibility and higher cost were the most common disadvantages. The specialisation and the clinical experience did not significantly affect the attitude of the practitioners.
Aim:
The study was aimed to evaluate circumferential crestal bone level after one year of implant placement with flapless versus flap surgery using surgical template after immediate loading in the posterior mandibular region using CBCT.
Setting and Design:
The study was designed as a Randomized controlled trial.
Material and Methods:
32 implants were placed in single edentulous spaces in the mandibular posterior region after random allocation into two groups: Flap surgery (Group A) and Flapless surgery (Group B). Virtual implant planning was performed using Blue Sky Bio software, and static CBCT guided 3D printed surgical templates were fabricated for all participants of both the groups. Immediate non-functional temporization was performed. Circumferential crestal bone levels were assessed after surgery and one-year follow-up using CBCT and XELIS software. Vertical bone loss (VBL) and horizontal bone loss (HBL) was assessed on four sides: buccal, lingual, mesial and distal.
Statistical Analysis Used:
Data was analyzed using Statistical Package for Social Sciences IBM Corp. Released 2017, IBM SPSS Statistics for Windows, Version 25.0. (Armonk, NY: IBM Corp.) and Graph Pad Prism 7.0 version. The level of significance was chosen <0.05. Chi square test was performed to assess the difference in the age in the two groups. Mann-Whitney U test was performed to compare the two groups for outcome measure. Graphically, quantile-quantile (Q-Q) plot was made using mean and standard deviation for normality verification of data.
Results:
100% survival rate and patient compliance was observed along the one-year follow-up duration. By using Mann-Whitney U test, statistically significant difference was found in the vertical bone loss among participants of Flap surgery (Group A) and Flapless surgery (Group B) on all the four sides after one year of implant placement. However, significant results were not obtained for the difference in the horizontal bone level.
Conclusion:
Within the limitations of this study, vertical bone loss measured circumferentially was more positively correlated with the implants placed with flap surgery compared to flapless surgery after immediate loading in the posterior mandibular region after one year.
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